HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
i Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION,
Address:
Ct' vz�� ' LCT1111 I I o"'
Legal Description:. fi 4� 1 1 C'b
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Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front
Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
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CONSTRUCTION INFORMATION:
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-hat, ap I
dditional work to be ertormed under this permit check allt p Y:
4NHVAC %-I Windows/Doors
n Gas Tank Gas Piping .J Shutters
Electric Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 50 1
Ft. of First Floor:
Utilities: ]Sewer Septic
Building Height: ___
OWNER/LESSEE:
CONTRACTOR:
am
Ne
'mow'e.*C-
Name .
Address: i C
Company:. 4C
city: i k.,f C_ State-_,o'
Address: jeQY-CVn i eL #111
Zip Code: Svl C1 Fax:
city:eoit,4- S��' luc State: L_
Phone No, 3
Zip Code: :3q 9 Fax: 77Q
E-mail:
Phone No. '7 % -7 1 -45W
fill in fee simple Title Holder on next page if different
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E -Mail: of 01ee� 'c�scr
from the Owner listed above)
State or County License-, C
If value of construction is $2500 or more,, a RECORDED Notice of Commencement is required.
.9"AL CONSTRUCTION: LIENILAW INF
DESI GNER/ENGI NEER: Not pplicable
Name:
Address.
City: "State:
Zip: Phone
FEE SIMPLE TITLE HOLDER:
Not Applicable
Name:
Address:
city:
Zip: Phone:
BONDING COMPANY:
Name. -
Address:
City:
Phone-,
—Nn, -.'L'- ApplicaUe
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and', insWlation as indicated.
I certify that no work or installation has commenced prior to the 'issuance of a permit.
St. Lucie County makes no representation that is granting aP ermit will authorize the erit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules,, bylaws or andcovenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER; Your failure to Record a Notice of Commencement may result In your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
,-.ommencigV W or mrecording_your Notice of Comencem
o,
Signature of Owner/ Lessee/Contractor as Agent for Owner Signaturk/of Contractor/License Holder
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STATE OF FLORIDA I I STATE OF FLORIDA
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COUNTY OF
COUNTY OF
The forgoing instrument was acknowledged before me
this d a y of 0 (" 11'10� 20JJ by
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�r
- b t "' Y)
Name of person making statement
Personally Known X OR Produced Identification
Type of Identification
Produced
,(Signature of IT6-tary Public- State of Florida )
I—- I
1000.0 Daniel 90496
0*400-IFF., i
The for oing instrument was acknowledged before me
this day of 20 by
Name of person making statement
Personally Known --)( OR Produced Identification
Type of Identification
Produced
(Signature of Notary PubState of Florida
Comm sir T. V_ _W -W 'W IF W - - - __ al)
NoWy pW�tMe of FWWa
Michelle Daniel
My COMMIssion FF 906496
RE ,y 'w FwRwO—NT- . "4"fOVI G SUPERVISOR PLAN 5"w VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17
AHRI Certified Reference Number: 201664062 Date: 10-17-2018 Model Status : Active
Old AHRI Reference Number: 8224170
AHRI Type: HRCU-A-CB
Outdoor Unit Brand Name: RUUD
Outdoor Unit Model Number (Condenser or Single Package): RP1530BJl
Indoor Unit Model Number (Evaporator and/or Air Handier): RH1T3617STAN
The manufacturer of this RUUD product is responsible for the rating of this system combination.
Rated as follows in accordance with the latest edition of ANSI/AHRI 210/240 with Addenda 1 and 2, Performance Rating of Unitary
Air -Conditioning & Air -Source Heat Pump Equipment and subject to rating accuracy by AHRI-sponsored, independent, third party testing:
Cooling Capacity (A2) - Single or High Stage (95F), btuh : 29400
SEER: 15.50
EER (A2) - Single or High Stage (9517): 13.00
Heating Capacity (H12) - Single or High Stage (47F) : 27000
HSPF (Region IV): 9.00
t"Active" Model Status are those that an AHRI Certification Program Participant is currently producing AND selling or offering for sale; OR new models that are being
marketed but are not yet being produced." Production Stopped" Model Status are those that an AHRI Certification Program Participant is no longer producing BUT is still
sellinor offering for sale.
Ratings that a i WAS indicate an involuntary J
�e-ra�te. The neg&gblished rati Q is shown alod, C�
-with th revio s, e. W tin%
,y
DISCLAIMER
AHRI does not endorse the product(s) listed on this Certificate and makes no representations, warranties or guarantees as to, and assumes no responsibility for,
the product(s) listed on this Certificate. AHRI expressly disclaims all liability for damages of any kind arising out of the use or performance of the product(s), or the
unauthorized alteration of data listed on this Certificate. Certified ratings are valid only for models and configurations listed in the
directory at www.alirid!rectory.org.
TERMS AND CONDITIONS
This Certificate and its contents are proprietary products of AHRI. This Certificate shall only be used for individual, personal and
confidential reference purposes. The contents of this Certificate may not, in whole or in part, be reproduced; copied; disseminated; on -III
entered into a computer database; or otherwise utilized, in any form or manner or by any means, except for the user's individual,
personal and confidential reference. AIR-CONDITIONING, HEATING,
CERTIFICATE VERIFICATION & REFRIGERATION INSTITUTE
The information for the model cited on this certificate can be verified atwww.ahridire etory-org, click on "Verify Certificate" link we make fife better -
and enter the AHRI Certified Reference Number and the date on which the certificate was issued,
which is listed above, and the Certificate No., which is listed at bottom right.
@2018Air-Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 131842752449024926